Predictors of lifestyle intervention outcome and dropout: the SLIM study

• Published in: European journal of clinical nutrition Vol. 65; no. 10; pp. 1141 - 1147
• Main Authors: ROUMEN, C, FESKENS, Ejm, CORPELEIJN, E, MENSINK, M, SARIS, Whm, BLAAK, E. E
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.10.2011
• Subjects: adults; Aerobic capacity; Aged; Anthropometry; Biological and medical sciences; Blood Glucose - analysis; Blood Glucose - metabolism; Blood Pressure; Body Composition; Body mass; Body Mass Index; Body size; Body Weight; Carbohydrates; Cardiorespiratory fitness; Care and treatment; Chromium; Clinical outcomes; design; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - prevention & control; Diet; Dietary Carbohydrates - administration & dosage; Dropouts; Energy Intake; Exercise; Feeding. Feeding behavior; Female; finnish-diabetes-prevention; Food, Organic; Fundamental and applied biological sciences. Psychology; Glucose; Glucose intolerance; Glucose Intolerance - diet therapy; Glucose Intolerance - metabolism; Glucose tolerance; Glucose Tolerance Test; Health aspects; Health risks; Homeopathy; Homeostasis; Humans; impaired glucose-tolerance; Insulin; Insulin resistance; Intervention; Life Style; Lifestyles; Lipids; Lipids - blood; Male; Males; Materia medica and therapeutics; Maximum oxygen consumption; Medical sciences; Metabolic diseases; Middle Aged; Motor Activity; Netherlands; Oxygen consumption; Patient Dropouts - statistics & numerical data; Patient outcomes; people; Physical activity; Physical fitness; Predictions; Prevention; Preventive medicine; Public health; randomized controlled-trial; reduction; risk; Risk Factors; Socioeconomic Factors; Socioeconomics; Therapeutics; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Netherlands; Prognosis; predictors of success; long-term lifestyle intervention; Prediction; Evolution; Metabolic diseases; Glucose; Metabolism; Long term; glucose metabolism; Life style; prevention; Diabetes; lifestyle
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/ejcn.2011.74

To evaluate the effect of a 4.1-year (range 3-6 years) lifestyle intervention according to general public health recommendations on glucose tolerance and dropout in a Dutch population with impaired glucose tolerance (IGT). In the Study on Lifestyle intervention and Impaired glucose tolerance Maastricht, 147 Caucasian IGT subjects were randomized to an intervention group (INT: n=74; 38 male, 36 female) and control group (CON: n=73; 37 male, 36 female). Annually, subjects underwent measurements of body weight, anthropometry, glucose tolerance (oral glucose tolerance test), insulin resistance (homeostasis model assessment-insulin resistance), maximal aerobic capacity (VO(2) max), blood lipids and blood pressure. INT received individual advice regarding a healthy diet and physical activity. INT decreased their saturated fat intake, increased their carbohydrate intake (P<0.05) and VO(2) max (P=0.04) compared with CON. Body weight did not change significantly (P=0.20) between the groups. After an initial decrease, 2-h glucose levels overall increased in INT (+0.11 mmol/l), but significantly less than CON (+1.18 mmol/l; P=0.04). Diabetes incidence was lower in INT versus CON (30 versus 56%, P=0.04). Change in body weight was associated with change in 2-h glucose levels (β=0.399 mmol/l per kg, P=0.02). Dropouts had a lower aerobic fitness and socioeconomic status, and a higher body mass index (BMI) and 2-h glucose compared with non-dropouts. Prolonged feasible changes in diet and physical activity prevent deterioration of glucose tolerance and reduce diabetes risk. Low socioeconomic status, low aerobic fitness and high BMI and 2-h glucose are indicative of dropout to the program.